health

TikTokers are promoting a diabetes drug as a weight loss fix. Now, the drug is in short supply.

"In three weeks I went down a whole dress size without 'trying' to diet. It took two shots..."

This is a standard snippet from one of the many thousands of TikTok videos touting claims of using diabetes medication for weight loss.

These videos, and the hashtag of a specific brand of diabetes drug, are currently racking up millions of views, and primarily involve users giving updates on their weight loss, tips on how to use the medication and its side effects.

A common question that crops up in the comment section? How to access the drug.

If you haven't seen these videos before, or don't know what diabetic medication does, its role is basically to balance blood sugar levels, making it an effective solution to obesity and diabetes. It is available on prescription from a general practitioner. 

However, in Australia, there's currently a nationwide shortage of the essential drug - meaning many people with diabetes and chronic health concerns don't have access to their medication.

Watch: TikTok users are using eyelash glue to get the appearance of bigger lips. Post continues below.


Video via Mamamia

The Therapeutic Goods Administration recently released a joint statement, urging health professionals to only prescribe and dispense the treatment for its approved use - to manage type 2 diabetes. 

The statement said the essential and continued care of people with type 2 diabetes needed to be prioritised, and warned those using the medication for weight loss may not have their prescription filled.

As Mamamia found out, even those with diabetes are being turned away. For some, this could be life-threatening. 

And, what does this mean for people suffering from chronic health conditions that could potentially lead to diabetes? The reality is that the potential impact on the future healthcare system could be huge.

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For many of Australia's health practitioners and pharmacists, it seems like a double-edged sword - obligating them to make difficult decisions.

But are these viral videos on TikTok really to blame for the current shortage? What impact is it having on those with diabetes, and is this issue only adding to the stigma surrounding obesity?

Diabetes medication and off-label use.

In Australia, diabetes medication currently falls under the Pharmaceutical Benefit Scheme (PBS) for those with type 2 diabetes who meet specific criteria.

Mamamia spoke with Dr Preeya Alexander, who explained the difference between Australian and overseas regulations.

She said, "In the United States, the Food and Drug Administration (FDA) has approved the medication for weight management in patients who are suffering from complications of obesity or being overweight, such as high blood pressure or type 2 diabetes."

While there are studies that suggest this medication can be helpful with weight management, Dr Alexander said it is currently not on the PBS for this indication in Australia.

Meaning? For weight loss, it's classified as 'off-label use'.

"Currently in Australia, the medication is not funded for weight loss alone, although it can have a place in this area for those who meet specific criteria."

"It is important to point out that the studies have specific criteria for whom the medication might benefit, at which BMI it could be considered and with which co-morbidities."

According to Dr Alexander, the real concern with the current trend on social media is that it's being implied the medication can be used for any weight loss. This is not the case.

"Studies have looked at particular patients using this medication - including those with a BMI over 30 or a BMI over 27 with obesity-related diseases such as hypertension (high blood pressure)."

"Social media influencers are suggesting this medication is for anyone who wants to lose weight when that is not the case. There are risks with any medication, and for any medication we consider risk versus benefit and the scales need to tip for benefit for us to consider prescribing something."

Read: Diabetes medication is not a magic bullet - and it comes with very real and very serious side effects. And it has been studied in particular groups of people who meet a particular criteria.

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"As health professionals, we can consider the use of diabetes medication and other medications for weight loss if indicated, but we reserve it for patients who meet specific criteria and are likely to yield health benefits."

"This is critical: patients who are overweight or obese with related medical conditions (like high blood pressure or cholesterol issues) are at a higher risk of other conditions like strokes and heart attacks." 

For these patients, this medication can be life-altering.

"Some weight loss for these patients can significantly change health outcomes, reduce risk of heart disease, type 2 diabetes etc - and so in those patients, after much discussion, we can consider use of these medications for weight loss."

How hard is it to get diabetes medication in Australia?

Carol is in her 50s and has type 2 diabetes. She hasn't been able to access her medication for over a month.

"I've been following up the drug company, telling them I haven't had a dose for over a month - it's a weekly injection. I’ve been unable to even put my script into the pharmacist because there is no supply," she shared.

"I've got a pharmacy I've been going to for decades and they won't even take my script. You keep thinking, it's coming in, it's coming in - and then you're just kind of left waiting. It's so unreliable. There's a lot of anxiety."

This prolonged period without the medication has had major side effects - including blood sugar levels and digestive issues.

"My GP has even followed up with pharmacies - she's given up prescribing it. I saw her recently and actually had a blood test. So, it will be interesting to see how my body has coped for the last month."

Dr Alexander said this also reflects what she's seeing in her general practice clinic.

"It's terrible. I have patients currently who cannot access the medication, and I have colleagues in the same boat."

"We have patients who meet the criteria for use - those with type 2 diabetes, for instance, who have poor glycaemic control over their current medication regime," she said.

"This medication could seriously positively change their health outcomes; improve their glucose control and induce some weight loss, which also helps fertility in PCOS and blood pressure management (if required)."

For patients like Carol, there is no substitution for her diabetes medication - she can either skip her weekly dose or opt for a lower dose. Or plead with the drug companies.

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"I wrote to the drug company that manufacturers the diabetes medication. They didn't respond. Four days later, I emailed them again and asked them to respond to me by close of business. I ended up getting a very generic response," said Carol.

"Personally, I think the problem is with the supply chain rather than just everyone using it."

"Previously, you could go to a chemist and there were four different types of scripts. The PBS, you could get one if you're a pensioner and a private script where you paid full price for it. What my GP explained to me was that there's another injectable that is prescribed for weight loss, but it costs at least double of what she does on a private script. So, that's why people have been using her."

However, one thing Carol makes clear is that she doesn't blame those taking it for weight loss or other chronic health conditions. 

"If it works for people who are using it for other conditions such as weight management, then so be it. There should be enough for everybody that needs it. You can't really discriminate."

"I was once pre-diabetic, and I was struggling with my weight - and I wish I intervened because I wouldn't have ended up this way."

It's important to note that for a lot of people using this medication off-label, it's not just because of some TikTok trend. It's for the betterment of their health.

Mamamia spoke to Erin, who has been taking this specific brand of diabetes medication for years. 

She told Mamamia, "I'm not diabetic, but other medications I take for chronic conditions have caused me to gain about 25kg over the past three years. I'm unable to lose weight, but this diabetes medication has been a lifesaver for me. I'll be able to get back to my usual healthy weight and, as a result, will no longer be at risk of type 2 diabetes."

Shannon, a pharmacist, offers a perspective from the other side of the counter.

"Due to the shortage (that was not caused by anyone in particular - the manufacturer didn't think the drug would be as popular as it has been so is struggling to keep up with the demand) I'm being asked by drug reps to prioritise patients over those using it for weight loss."

"Who am I to exclude the proportion of the population from a potentially life-saving medication? Obesity can lead to type 2 diabetes - this is well documented. Patients who already have established disease are not more important than those trying to prevent it. It's unethical and I'm struggling with it."

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TikTok and the prevalence of diet culture.

In 2022, diet culture is more prevalent than ever - and TikTok, like other social media platforms, is rampant with content that promotes weight loss, dieting and harmful behaviours. And it's extremely dangerous.

Body-positive influencer, blogger and registered nurse Lacey-Jade Christie said these viral TikTok videos and the current medication supply shortage reflect the very real pervasiveness of diet culture and body shaming. 

She said it is clear that 'fatphobia' in Australia is thriving.

"I have been a nurse for ten years and have witnessed fatphobia in the medical industry first-hand, both as a healthcare provider and as a patient, so I wish I could say that I'm surprised, but I'm not."

"I speak about medical fatphobia and doctors suggesting extreme weight loss measures on my platforms a lot because I want people to be as informed as possible when making decisions like having weight loss surgery or spending $150 on an injection, and I want them to be able to advocate for themselves."

"And every time I bring up the subject, I am inundated with people telling me their heartbreaking stories of doctors shaming them into treatment or making them feel guilty if they fail to lose weight."

Many TikTok users promoting the use of diabetes medication for weight loss take followers on their transformation 'journey' - showing how the medication has suppressed their appetite, what they eat in a day and the changes in their body. 

These videos are getting thousands upon thousands of views.

"First of all, any kind of trend that sees people celebrating weight loss, in such an open manner on such a large scale, reinforces the notion that being fat and existing in a larger body is the worst way for a person to live," said Lacey-Jade.

"It tells an already vulnerable community that there is something wrong with them and that their weight can be 'fixed' with very expensive medication." 

@littlefreakcailyn doctors don’t see fat people as humans…. #ozempic #weightloss #fat ♬ As It Was but make it sad - Naina Singh

"Encouraging people to lose weight via extreme measures, such as surgery and medication, without also giving them access to psychological treatment and nutritional education is irresponsible and it may not work for everyone."

"It's also important to remember that people who suffer from disordered eating behaviour and eating disorders are so vulnerable to these kinds of 'quick fixes', but they don't help to heal a person's relationship with food. And if they 'fail' to lose weight or gain it back (which 96 per cent of dieters do) then they can end up back in a vicious cycle of self-hatred and disordered eating."

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One of the most common queries that arises in the comment section of these viral videos is how to access the drug. 

One comment on a viral video reads, "Do you have to fit a criteria to qualify for this? I’m going to my GP [on] Friday to ask if I can be prescribed it."

Another comment reads: "My doctor won't give me a script. She said I need to see a specialist."

The user replies: "Try my weight loss clinic."

Dr Alexander said, "I think people need to realise that there are specific indications for this medication, and just because an influencer suggests it is great for weight loss - does not mean it is for everyone." 

"And let's be clear - not all weight loss is good. We are getting into a dangerous territory again on social media where the suggestion is that health is defined by weight or BMI alone - and as a GP, I can tell you that is simply not true. I can also tell you that not all weight loss is good or 'healthy.'

As a platform, TikTok thrives off its perceived reliability, accuracy and authenticity. However, the reality is that social media platforms should not be used for health advice. It's crucial for us, as users, to avoid following this kind of advice from people online.

"Please consider that this medication is required by those in the community with complex health issues like type 2 diabetes, PCOS, high blood pressure and they cannot access it right now due to shortages. Please also consider this medication can have side effects," said Dr Alexander.

"For influencers to glamorise a medication that induces weight loss is not helping many of the issues we are seeing on the ground around body image and eating disorders," she concludes.

For help and support for eating disorders, contact the Butterfly Foundation‘s National Support line and online service on 1800 ED HOPE (1800 33 4673) or email [email protected] 

You can also visit their website, here.

Feature image: TikTok/Mamamia

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